Over 1.5 million people need social care because of smoking
23 March 2021
A new report  published today by Action on Smoking and Health (ASH) shows that, on average, smokers in England need care when they are 63, ten years sooner than non-smokers. The analysis, by Landman Economics for ASH, finds that 1.5 million people need help with everyday tasks, such as dressing, walking across a room and using the toilet due to smoking.
This high level of social care need has a significant impact on local authority social care budgets. It’s estimated that 102,500 people are receiving local authority funded care as a result of smoking (85,000 in their home and 17,500 in residential care). This adds up to £1.2 billion each year, equivalent to 8% of the country’s social care budget for home and residential adult care. Although smoking costs the NHS more than double this, at £2.5 billion annually  this is only 2% of the NHS’s much larger budget.
Smoking is the leading cause of premature and preventable death in the country, killing 74,600 people in England in 2019 alone.  For every person killed by smoking, at least another 30 are estimated to be living with serious smoking-related disease and disability. 
The report reveals that:
- More than one and a half million adults in England (1,647,500) have social care needs as a result of smoking.
- More than one million of these (1,095,000) are receiving support from a partner, relative, friend or neighbour who work unpaid to meet social care needs caused by smoking.
- More than 100,000 people receive local authority funded care as a result of smoking (85,000 in their home and 17,500 in residential care).
- Overall, current smokers and recent ex-smokers are 2.7 times more likely to receive social care support provided unpaid and informally by a relative, friend or neighbour, than never smokers.
- A further 450,000 people in England who have social care needs as a result of smoking receive no support. Current smokers and recent ex-smokers are 2.5 times more likely to have unmet care needs than never smokers.
Deborah Arnott, Chief Executive of Action on Smoking and Health, said:
“This report reveals the shocking extent to which smoking damages the quality of people’s lives, and of those around them, before going on to kill them prematurely. On average smokers need social care at 63, ten years earlier than non-smokers, so if the Government truly wants to extend healthy life expectancy by five years by 2035, ending smoking is a priority.”
“However, achieving the Smokefree 2030 target won’t be easy and requires investment at a time when the Government has a massive budget deficit. Tobacco manufacturers on the other hand remain extremely profitable and should be made to pay a levy on their sales as they do in the US, to help make smoking obsolete.”
Cllr Ian Hudspeth, Chairman of the Local Government Association’s Community Wellbeing Board, said:
“The substantial impact smoking has on council finances and social care costs reinforces the case for urgent investment to reduce smoking and achieve the Government’s ambition of a smokefree country by 2030. Public health funding has not kept pace with funding for the NHS and this must change if local government is to play a full role in improving the health of the nation.
“The forthcoming Spending Review must be the moment to put public health and social care on a sustainable footing so that councils can continue their vital work in supporting, promoting and improving people’s wellbeing.”
Stephen Chandler, Director of Adult and Housing Services at Oxfordshire County Council, said:
“This analysis shows how interconnected our health and care system is. Investment in tackling smoking today can help us to meet the care needs of our communities in the future. This must form part of our overall strategy to address the growing pressures on the social care system.”
 Action on Smoking and Health (ASH). The cost of smoking to the social care system 2021. March 2021.
 Department of Health. Towards a smokefree generation: A tobacco control plan for England. July 2017.
 NHS Digital. Statistics on Smoking, England, 2020. December 2020.
 U.S. Department of Health and Human Services. The Health Consequences of Smoking—50 Years of Progress: A Report of the Surgeon General. Atlanta: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, 2014.